Hip Adduction

Actually, hip adduction is every bit as buzz-worthy as barefoot running. Why? Because hip adduction is a simple assessment of running form and a key determinate of the propensity for injury. Excessive hip adduction is correlated with a variety of running related alignments.

According to incoming Director of the Harvard Medical School's Spaulding National Running Center, Dr. Irene Davis, "Hip adduction misaligns the lower extremity–so rather than the leg being loaded in a 'well-stacked' position, the leg is abnormally loaded and can adversely effect the musculoskeletal system." In more common runner speak, she adds, "We have found excessive hip adduction related to runners knee, IT Band Syndrome and tibial stress fractures."

Kevin Stone, MD, founder of the Stone Clinic, agrees: "Excessive adduction would really increase the valgus force at the knee as well as throw someone into extra pronation, so it could mechanically be a problem with long distance running."

Measuring hip adduction is relatively straightforward. I recently had a biomechanical assessment performed at the UCSF Human Performance Center. It involved running on a treadmill while being filmed from various angles. A complete report was generated from this assessment. Thankfully, I had very little hip adduction. In comparison to the control group, whose hips drop into approximately 15 degrees of adduction, my drop was less than two degrees throughout the running cycle.

This, of course, begs the question: If excessive hip adduction is correlated with injury, and if it's fairly straightforward to measure, why aren't more people having the test done? I imagine this will be changing in the near future.

Knowing you have excessive hip adduction is one thing, but correcting the problem is another. For more on this, I turned to the Director of Research at the UCSF Human Performance Center, Dr Richard Souza: "Right now there are two schools of thought–hip muscle strengthening and gait retraining. Overall, the strengthening approach has moderately strong evidence that it is effective. Dr. Irene Davis's group is leading the efforts on gait retraining and has shown remarkable results in a limited number of studies." I also asked Dr. Souza if there is a device that could potentially help. "There is one device that I know of that was developed by my dissertation adviser called the S.E.R.F. Strap (Stability thru External Rotation of the Femur) by DonJoy Orthopedics that improves rotation and adduction," he tells me. Other than that, "I am not aware of anything else."

So there you have it. A menacing problem. A clear diagnosis. Little in the form of treatment. I imagine we'll be hearing more about hip adduction in the years to come.